Search results

The most recent wave of the opioid epidemic in the USA has been complicated by a sharp increase in methamphetamine use. In addition, many people classified with opioid use disorder (OUD) and methamphetamine use disorder (MUD) present indications of psychiatric conditions. These diagnoses are also highly prevalent among people who are admitted to jails, but research conducted with this population is limited, due in part to the challenges associated with gaining access to local detention centers. This paper aims to examine the patterns of psychiatric conditions, OUD, and MUD among an understudied population to help inform the development of service delivery systems.

The present study was designed to assess the prevalence of OUD, MUD and common psychiatric conditions in a large sample of adults (n = 846) collected from four local jails. Diagnostic patterns were evaluated according to the current criteria established in the Diagnostic and Statistical Manual of Mental Disorders (5th ed; American Psychiatric Association, 2013).

More than half (57.3%) of the sample met criteria for MUD, one-third (37.2%) exceeded the threshold for an OUD diagnosis and 15.7% were classified with both conditions. Participants who met criteria for both MUD and OUD were significantly more likely to experience symptoms of major depression [adjusted odd ratios (aOR) = 1.76, 9, confidence intervals (CI) = 1.16–2.67], post-traumatic stress disorder (aOR = 2.51, 1.64–3.83), panic attacks (aOR = 3.24, 95% CI = 2.05–5.13), obsessive compulsive disorder (aOR = 2.74, 95% CI = 1.66–4.51) and antisocial personality (aOR = 3.03, 95% CI = 1.97–4.64).

These results, which were derived from an understudied population of adults detained in local jails, indicate the co-–occurrence of MUD and OUD are associated with certain psychiatric conditions.

Drug cryptomarkets increase information available to market actors, which should reduce information asymmetry and increase market efficiency. This study aims to determine whether cryptomarket listings accurately represent the advertised substance, weight or number and purity, and whether there are differences in products purchased from the same listing multiple times.

Law enforcement drug purchases – predominantly cocaine, methamphetamine, MDMA and heroin – from Australian cryptomarket vendors (n = 38 in 2016/2017) were chemically analysed and matched with cryptomarket listings (n = 23). Descriptive and comparative analyses were conducted.

Almost all samples contained the advertised substance. In most of these cases, drugs were either supplied as-advertised-weight or number, or overweight or number. All listings that quantified purity overestimated the actual purity. There was no consistent relationship between advertised purity terms and actual purity. Across the six listings purchased from multiple times, repeat purchases from the same listing varied in purity, sometimes drastically, with wide variation detected on listings purchased from only one month apart.

In this data set, cryptomarket listings were mostly accurate, but the system was far from perfect, with purity overestimated. A newer, larger, globally representative sample should be obtained to test the applicability of these findings to currently operating cryptomarkets.

This paper reports on the largest data set of forensic analysis of drug samples obtained from cryptomarkets, where data about advertised drug strength/dose were obtained.

This study aims to examine the role of Australian casinos in facilitating money laundering and Chinese capital flight.

The reports and transcripts of evidence from government inquiries into money laundering in Australian casinos are integrated with analyses of Asian transnational crime.

Money laundering in Australian casinos is linked to transnational crime and Chinese capital flight. A central finding is that junket operators play a key role in facilitating money laundering. The casinos are particularly exposed to criminal influences in the Chinese very important person gambling market, since they have used junket operators and underground banks, many of whom are closely linked to major Chinese criminal groups from Hong Kong and Macau.

Very little information is available on money laundering in Australian casinos and this research has relied on the government inquiries that have been conducted over the past two years on the subject.

The author’s focus on money laundering in Australian casinos in the context of Asia-Pacific transnational crime is important for Federal and state government regulators grappling with the rapidly changing money laundering issues. The government inquiries recognised that the money laundering was related to transnational crime, but did not have the time and resources to explore the topic. The paper provides state government casino regulators and financial crime regulators with a broader international perspective to anticipate future money laundering and crime pressures facing Australia’s casinos.

Money laundering in Australian casinos has had devastating social implications on the community. My research helps to focus attention on the problems of transnational crime and money laundering.

Little research has examined the linkages between casinos and transnational crime. This study has found that Australian casinos were used to launder the proceeds of illegal drug trafficking and to facilitate Chinese capital flight. While casinos have been forced by damming government inquiries to tighten anti-money laundering controls, it is likely that there will be pressure to relax these controls in the future because of competitive pressure from other casinos in the Asia-Pacific region.

Repetitive transcranial magnetic stimulation (rTMS) is a well-established treatment with efficacy for several psychiatric disorders and has yielded promising yet mixed data showing reductions in craving for substance use. Patients with substance use disorders and comorbid depression may encounter obstacles to receiving rTMS in outpatient settings for treatment of depression. In turn, implementation of rTMS in residential substance use programs would greatly benefit those with comorbid treatment resistant depression. This paper aims to provide recommendations for implementing rTMS within residential substance use treatment centers.

Using PubMed, the authors conducted a narrative review of manuscripts using various combinations of the following search terms: rTMS, depression, substance use and substance use disorder. The authors read manuscripts for their methodology, outcomes and adverse events to synthesize their results, which correspond to their recommendations for patient selection, safely implementing rTMS in residential substance use facilities and optimal rTMS protocols to start with.

Advantages of this approach include increased compliance, monitoring and access to care. Recommendations to safely incorporate rTMS in residential substance use disorder treatment centers revolve around selection of patients eligible for rTMS, allowing for sufficient time to elapse prior to commencing rTMS, monitoring for signs of recent substance use or withdrawal and using rTMS protocols compatible with the therapeutic programming of a treatment center.

This paper details the challenges and benefits of implementing rTMS for patients with dual diagnosis and provides recommendations to safely do so. To the best of the authors’ knowledge, this is a novel and unpublished endeavor.

Identifying the health-related needs in transgender (TG) people can help to formulate strategies for providing appropriate and accessible health services and promoting health and social justice, as well as human rights in these populations. This systematic review aims to determine health-related needs, problems and barriers, as well as ways to solve them in TG people from the viewpoint of TG individuals and health policymakers.

All international electronic databases such as PubMed (Medline), Embase, CINAHL, Scopus, Web of Sciences, Cochrane, PsycInfo and Google Scholar (Gray Literature) were searched from December 1990 to December 2019. After the search, the articles were screened based on their title, abstract and full text. The quality of articles was assessed using the Strengthening the reporting of observational studies in epidemiology (STROBE), Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Qualitative Research (SRQR) checklists. The search strategy, data extraction and quality evaluation of articles were independently performed by two researchers.

The general health-related needs identified in TG individuals from the viewpoint of themselves included access to legal hormone therapy, psychological and psychiatric counseling, privacy, health and hygiene needs, equality and freedom of expression. General health-related needs in TG individuals from the viewpoint of health policymakers included screening tests to detect sexually transmitted diseases, especially HIV, cancers and other diseases, as well as training service providers (physicians, nurses, health workers, etc.).

One of the limitations of this study was nonreporting of health-related needs in initial articles by different TG groups because these groups have had different needs and different barriers to accessing health-care services. In this study, health-related needs and barriers to satisfy them were categorized from the viewpoint of TG populations and health policymakers around the world, which may influence future decisions to provide services to TG populations. The results of this systematic review can help to develop different strategies by considering all TGs from individual, family and social aspects to better provide services for this group. However, given the dynamics and changes in the existing communities and the limited studies on gender minorities in developing countries, further research is required to comprehensively address the subject.

The findings can be used as an incentive to improve existing conditions and to address problems and shortcomings. The results of this systematic review formulate strategies for providing appropriate and accessible health services and better lives for TGs, planning for more effective participation of these individuals in local communities, improving their physical problems and mental health through counseling, as well as promoting health and social justice, and human rights for these populations.

This study aims to explore the dynamics involved in the non-medical use of tramadol among manual labourers in Nigeria.

Using the phenomenological approach, we conducted in-depth interviews with forty (40) manual labourers (age: 19–36 years). These participants were selected through purposive and snowball sampling techniques from two cities in Anambra state, Nigeria, and the data was analysed with thematic analysis.

The results revealed that most of the participants were introduced to tramadol use by their friends. They used tramadol for pain relief, euphoric feeling, energy for work and sexual performance. Unfortunately, most of them may have gradually become dependent on this drug to function well in life without knowing the possible medical and psychological implications.

The sample choice may limit the generalization of the findings; however, the study indicates a need to improve working condition, access to healthcare and awareness of the negative effects of non-medical use of tramadol.

Non-medical use of tramadol may have started as an attempt to help self in performing the daily routine. This action can jeopardize an individual’s mental health and, at the extreme state, hinder performance of daily routine. Friends and the quality of information they provide play a significant role in the onset of this action. The strong point is that many people who are involved in the non-medical use of tramadol are unaware of the possible risks. Improving working conditions and access to healthcare for chronic pain could help reduce these risks.

Prisoners with substance use disorder (SUD) are at risk of mental health problems. Given the common co-occurring of psychopathic traits with SUDs, probably because of underlying impulsive traits (Ellingson et al., 2018), this study aims to examine the relation between psychopathy (impulsive antisociality and fearless dominance) and the functioning of incarcerated individuals with SUD. The authors investigated whether impulsivity (motor, nonplanning and attentional) can account for the relationship between one psychopathy facet (impulsive antisociality) and craving and mental health problems.

The authors assessed self-reported impulsivity, psychopathy, craving and mental health problems in 121 male incarcerated individuals with SUD and calculated cross-sectional linear regression analyses and mediation models.

Impulsive antisociality was positively related to all impulsivity facets, craving and mental health problems. Attentional impulsivity mediated the relationship of impulsive antisociality with craving and mental health problems. Fearless dominance was related to lower attentional and nonplanning impulsivity, craving and mental health problems.

Future studies should investigate these relations in longitudinal studies and evaluate tailored approaches, for example, mindfulness interventions.

Interventions to reduce craving and improve mental health might be important for those who display self-centered, antisocial behavior but are less relevant for those with fearless, dominant interpersonal behavior. Addressing attentional impulsivity may be of special interest in this regard.

To the best of the authors’ knowledge, this study was the first to investigate the mediating role of different impulsivity facets for the association of impulsive antisociality with craving and with mental health problems in incarcerated individuals with SUD.

The purpose of this study is to examine why an attempt at suicide does not always indicate the beginning of a life with poor mental health.

Case studies, supplemented by follow-up studies of attempted suicides.

One of the strongest predictors of a healthy life after the suicide attempt was found to be improvement in the appropriateness of behavior toward others and improved adult functioning.

The results suggest that behavioral coaching, in addition to traditional psychiatric treatment, could help attempted suicides move on with their lives productively.